Everyday Oral Surgery

Today’s guest is Dr. Alan Felsenfeld, here to talk about how he has found meaning in his dynamic career through mentorship, community work, best practices, and building good relationships with patients and fellow residents. Dr. Felsenfeld is currently retired but still very active in the community, and he is still affiliated with the UCLA Medical Center where he was a full-time faculty member since 1995. Prior to that, he was in hospital administration, after which he trained to be an oral surgeon at County Hospital in Chicago and then went into private practice in the East San Gabriel Valley. Dr. Felsenfeld has made many pivots in his career and we talk about the motivating forces behind these changes, hearing him weigh in on the value of staying fulfilled. For him, teaching, leadership, and giving back to the profession were major driving forces, and he talks about how his choices lead him closer to these activities, thereby keeping him motivated and inspired. We also get into some of the technical sides of surgery, talking about the correct use of instruments and some of the difficult cases Dr. Felsenfeld undertakes in his capacity as an affiliate at a university medical center. We also have a great discussion about Dr. Felsenfeld’s abilities to communicate so well, and he speaks about how far humor, jargon avoidance, and not taking himself too seriously can go in daily relations. Tune in today!Key Points From This Episode:A brief history of Dr. Felsenfeld’s training and current affiliation with UCLA.Advice for young surgeons who want to give back despite post-medical school debt.Dr. Felsenfeld’s path into academia and how he stays motivated on a daily basis.How Dr. Felsenfeld bypasses the political aspects of working in academia.Having several career pivots and why Dr. Felsenfeld gave a lecture on reinventing yourself.A closer look at why and how Dr. Felsenfeld transitioned from hospital administration into oral surgery.Dr. Felsenfeld’s memories of training in Chicago, his co-residents, and the fun times they had.Mandibular tori, implants, extractions: Surgeries Dr. Felsenfeld performed recently.Common mistakes Dr. Felsenfeld sees younger surgeons make; correct tool usage.Difficult cases Dr. Felsenfeld deals with and how these cases are often referred to universities.Communication tips: Having good humor, avoiding jargon, not taking yourself too seriously.Things Dr. Felsenfeld does to take his mind off his job; why he loves flying small planes.How difficult but important it is to stop performing surgeries once you get too old.Dr. Felsenfeld’s experiences with his grandkids and what they are interested in.Final words from Dr. Felsenfeld about how to find meaning in an oral surgery career.Links Mentioned in Today’s Episode:Dr. Alan FelsenfeldUCLACounty Hospital ChicagoThe Dental Board of CaliforniaAAOMSDr. William FlickDr. Charles BertolamiDr. Grant Stucki Contact — 720-775-5843

In the discipline of oral surgery, cases can get complicated for highly technical reasons, but perhaps it is the emotionally complex cases that present the biggest challenges. Today, we speak to Dr. Ole Jensen about his experiences with challenging cases, also diving into the contributions he has made to the field of implants. Dr. Jensen received his DDS degree from Northwestern University School of Dentistry, completed his Anesthesiology Residency at Northwestern University School of Medicine, and his Oral and Maxillofacial Surgery Residency at the University of Michigan. His research interests are bone grafting, dental implants, and distraction osteogenesis, and he has authored three textbooks on oral surgery as well as more than 25 articles. Dr. Jensen begins our conversation talking about his dynamic education, sharing how he got interested in anesthesiology, oral and maxillofacial cancer, tracheostomy, intubations, and how he trained in the Brånemark System after his studies at ‘the school of hard knocks’. We move onto the subject of implants, and Dr. Jenssen talks about the groundbreaking contributions he has helped make to shape new technologies that enhance antimicrobial action to prevent peri-implantitis in different ways. Toward the end of our conversation, we talk about why Dr. Jensen is familiar with difficult cases and the reason that some of the most challenging ones are due to emotional reasons. Wrapping up, Dr. Jensen shares some lines from the Rambam physician prayer for oral surgeons who hope to give back to the community in ways as significant as his. Tune in today.Key Points From This Episode:An overview of Dr. Jensen’s education and training in the Brånemark implant system after school.Dr. Jensen’s pursuit of anesthesiology and the medical and surgery side of dentistry at college.The experience in intubations and tracheostomies Dr. Jensen had in his training.A case where a patient expired during an anterior mandibular dental implant replacement.The story behind ClearChoice and the role Dr. Jensen played in steering the company.Nanotechnology by Nobio to enhance antimicrobial action on implants to prevent peri-implantitis.The dental implant company called Ditron Dr. Jenssen started and the precision implants they make.The tolerance of microns between machine parts Ditron Ltd. makes which is too small for bacteria.Some of the work Dr. Jensen is still doing; starting an oral and maxillofacial surgery training program in Salt Lake City.Zygomatic implants and other tough cases Dr. Jensen did daily and why.Links Mentioned in Today’s Episode:Dr. Ole JensenClearChoiceUniversity of MichiganNorthwestern University School of MedicineNorthwestern University School of DentistryBrånemark SystemPer-Ingvar BrånemarkHadassahNobioDitron DentalDitron Ltd.University of UtahDr. Grant Stucki Contact — 720-775-5843

If oral and maxillofacial surgeons can find the time to commit to their local hospitals and associations beyond their private practices, the integrity of the specialty will be more securely protected. This is a belief held by today’s guest, Dr. Alexis Olsson, and his career shows it. Dr. Olsson is an Oral and Maxillofacial Surgeon practicing in Chicago, Illinois. He is currently Chief of Oral and Maxillofacial Surgery at Northwestern Memorial Hospital and Anne and Robert H. Lurie Children’s Hospital, as well as Professor of Clinical Otolaryngology and Head and Neck Surgery at Northwestern University Feinberg School of Medicine. He is also an active member in the oral and maxillofacial surgery community through his service to both AAOMS and well IAOMS. In this episode, we talk to Dr. Olsson about how he grew his practice to straddle the public and private spheres with such equal measure, while also hearing about as the techniques that have defined and are defining his practice today. We hear his thoughts on the current landscape of the oral and maxillofacial surgery specialty too, where he talks about the forces that are jeopardizing it, the need for new surgeons to take an active concern in its survival, and what is to be done in this regard. For a conversation rich in insights that span the technical and social sides of oral surgery, tune in today.Key Points From This Episode:Dr. Alexis Olsson’s education and career in both private and academic settings.How Dr. Olsson was able to grow his career in the academic as well as private space.Staying afloat in competitive downtown Chicago by being dedicated to patient care.The recent value of virtual surgical planning and new technology for Dr. Olsson’s practice.Challenges in Dr. Olsson’s career; less personal relationships between patients and doctors.Advice from Dr. Olsson for new surgeons who have a desire to protect the profession.Rewarding parts of being a teacher and Dr. Olsson’s hopes for his students’ futures.‘Taboo’ but effective techniques Dr. Olsson used early on and new tricks for optimizing surgery.How Dr. Olsson goes about doing implants generally – his case by case approach.When Dr. Olsson will do a flapless implant; biological characteristics of patients.Dr. Olsson’s philosophy of being conservative with soft tissue manipulation.The approach Dr. Olsson has to reconstructions and how things have become more aggressive.Dr. Olsson’s approach to doing molar immediate implants.What communication techniques and bedside manner should look like for surgeons.Final comments from Dr. Olsson about the need for oral and maxillofacial surgeons to protect their specialty and represent it well.Links Mentioned in Today’s Episode:Dr. Alexis OlssonNorthwestern UniversityNorthwestern Memorial HospitalLurie Children’s HospitalNorthwestern MedicineNorthwestern University Feinberg School of MedicineNorthwestern Dental CenterAAOMSIAOMSDr. Mark C. HuttenDr. Grant Stucki Contact — 720-775-5843

Succeeding as an oral surgeon is about far more than academic and clinical talent. It also requires you to be a leader and a salesperson. This is just one of the many great insights today’s guest, Dr. Thomas Schlieve, shares with us. With advanced fellowship training in oral, head and neck oncologic surgery, Thomas is the current Graduate Program Director at Parkland Memorial Hospital in Dallas. In this episode, we learn more about his pathology passion and how he has earned the nickname ‘The Dead Bone Doctor of Dallas’. Thomas walks us through some of the most common cases in his pathology-focused practice, along with his frustrations when trying to treat cancer. We hear about why he advocates for incisional biopsies, the importance of not waiting to intervene with head and neck cancers, and how having patients come in with biopsies eases his workload. The conversation then moves away from the surgical side of things, where we talk about growing as a leader to be a better surgeon. Here, Thomas shares what he has gained from How to Win Friends & Influence People and how he has applied this knowledge to improve his practice. As someone who works on the academic side of things, Thomas has a firsthand understanding of what it takes to be a great oral surgery resident, and we wrap the show up by hearing these top tips. For all this and more, be sure to tune in today!Key Points From This Episode:Get to know Thomas, his training, and what he is currently doing.The pathology cases that Thomas spends most of his practice time on.Thomas’s patient-specific approach to treating osteonecrosis and the techniques he uses.Advice Thomas has for effectively handling osteonecrosis.Thomas’s frustration when something cancerous is removed and no legion is left to see.Why you should not wait for a head or neck cancer to grow before intervention.How patients coming in with biopsies helps Thomas chart an effective course of treatment.The way that different margins are marked by pathologists.Hear why Thomas believes you should declare an excisional biopsy.Success as a surgeon is about more than clinical talent; you have to be a good leader too.How Thomas changed his approach to referrals and leadership generally.Takeaways from How to Win Friends & Influence People that Thomas and Grant have used in practice.The importance of letting patients vent and giving them space to offload.Thomas’ approach to patient education and giving them information feel most comfortable.Asking open-ended questions and mirroring: How these techniques get patients to open up.Being caring as a leader and how this helps all aspects of your practice.Why Thomas has grown more cautious about implants since his residency.Thomas's approach to immediate implants and being clear on timelines with patients.Hear what Thomas looks for in potential residents.The impact that upbringing has on the grit that is required to become a surgeon. Links Mentioned in Today’s Episode:Dr. Thomas SchlieveParkland HospitalSchool of Dentistry Marquette UniversityUniversity of Illinois at Chicago College of DentistryHow to Win Friends & Influence PeopleDale Carnegie TrainingDr. Grant Stucki Contact — 720-775-5843

Residency is the perfect learning environment for young maxillofacial surgeons, with valuable skills and know-how shared among professors and peers alike. Once qualified, the transition into private practice or starting a practice of your own can be quite daunting. Our guest today is an old-time friend and expert maxillofacial surgeon, Dr. William “Billy” Hull, who has plenty of guidance to share. To kick things off, we take a look at Billy’s academic and professional history. Having studied at The University Of Illinois At Chicago Medical Center, he has since moved into various private practice settings and is now a partner at his own practice. From picking the right partners to the best way you can build functional working relationships with them, Billy shares his biggest lessons with us. He then dives into seniority, hierarchy dynamics, and the best ways to manage compensation, before providing insight on why you should move into an established practice for your first gig. As our conversation continues, Billy talks about how he has evolved as a surgeon, telling us about his favorite tools and the reasons he uses them. Sprinkled throughout our conversation, Billy reminisces about his old days in residency, offering comical anecdotes and explaining why humor is an important part of his job. Remember to floss and be sure to tune in!Key Points From This Episode:Introducing today’s guest, maxillofacial surgeon Dr. William “Billy” Hull.Billy shares details about his professional history.Hear about the lessons Billy has learned over the years.How hierarchy can influence the success of a practice. Exploring the pros and cons of having a good partner.Why the relationships you build during residency are so important.The art of drawing up a partnership contract that fairly distributes compensation.Knowing what healthy competition is between partners.Hear Billy’s humorous anecdotes about his residency.Billy tells us how he has evolved as a surgeon since leaving medical school.Why spreading your legs can be better than bending over while performing surgery.Billy touches on why he won’t use a hall drill.Hear about the 703 and its finesse as an oral surgery tool.Find out how Billy’s incision design has changed over the years.Why PRF is preferred over dry-socketing. Billy’s preference of BioHorizons over Straumann and Nobel Biocare.Hear about how Billy keeps a balance between humor and professionalism.Links Mentioned in Today’s Episode:Dr. William Hull on LinkedIn.The University Of Illinois At Chicago Medical CenterBioHorizonsNobel BiocareStraumann

Talking less and listening more empowers your patients and helps you better serve their needs. This insight is provided by Dr. Justin Evanson of Pacific Dental Services. Today we speak to Justin about his work as an Oral and Maxillofacial Surgeon, what he’s done to overcome his challenges, and the ways that he’s improved his practice. We open our conversation by exploring his training and the procedures that he most commonly administers. He dives into what he has recently changed to make his daily routine better, including the new additions to his surgical kit. After talking about the benefits of a new suturing technique, we discuss why he prefers healing abutments to cover screws, and why Justin rarely conducts upper molar immediate implants. We ask Justin how he follows up with patients who have other dental providers, his answers highlighting the importance of communicating with both patients and their providers. We then touch on his approach to anesthesia which leads to Justin explaining how he quickly builds connections with his patients. Near the end of the episode, Justin reflects on his two most difficult cases and what he did to get through them. Tune in to hear more of Justin’s top tips on improving your oral surgery practice. Key Points From This Episode:We introduce today’s guest, Oral and Maxillofacial Surgeon Dr. Justin Evanson. Hear about Justin’s training at Parkland Hospital in Dallas, Texas.Justin shares details about his current practice and the procedures he often performs. Top tips from Justin on how you can improve your surgery.Using the figure-eight suturing technique developed by Dr. Daniel Buser. Swapping out different sized healing abutments over time. Why Justin rarely does upper molar immediate implants. Follow-up and dealing with patients who have other dental providers. Justin’s philosophy on anesthesia and how he applies it with patients. Exploring the most challenging aspects of Justin’s daily routine. How you can develop a connection with patients that you only see once or twice. Why Justin doesn’t talk people into procedures that they have reservations about. Offering quality care to all of your patients — even if that means long appointments. Details on Justin’s two most difficult cases and how he got through it.Justin shares some final practical advice to help listeners in surgery. Links Mentioned in Today’s Episode:Dr. Justin Evanson on LinkedInPacific Dental ServicesColumbia UniversityParkland Hospital UT Southwestern Medical CenterJohn Peter Smith HospitalBien AirVersahDr. Daniel Buser International Team for ImplantologySalvin Dental Specialists BaxterDigital Dental SolutionsZack ReynoldsNobel BiocareDr. Grant Stucki Contact — 720-775-5843

As a small community, oral and maxillofacial surgeons need to share what they have learned to ensure everyone's practice thrives. In today’s show, Dr. Raza Hussain gives us insights into the knowledge he has gained through both his academic and faculty surgery work. Raza practices in Chicago, where he is the Chief of Oral and Maxillofacial Surgery at the Jesse Brown Veterans Administration Medical Center. We dive right in, discussing Raza’s approach to dealing with peri-implantitis, where he shares why he uses the controversial implantoplasty as a treatment and the importance of collaborating with the restorative doctor. We then hear about the most difficult cases Raza has encountered working at a VA hospital. From transmandibular implant removal to necrotizing fasciitis, Raza has handled incredibly unique cases that many oral and maxillofacial surgeons are unlikely to encounter over the course of their careers. The conversation then moves onto protecting oral and maxillofacial surgeons’ outpatient anesthesia rights and why the current campaign to remove these rights is unfounded. Raza acknowledges that support staff might not be well-trained, but he believes that it is the practicing surgeon's responsibility to get his team on the same page. He shares what those of us in private practice can do to ensure we will continue to be allowed to do jobs in a way that is best for our patients. To hear this and more, be sure to tune in today!Key Points From This Episode:Get to know Raza, his professional experience, and what he’s up to now. The improvements that Raza has made with his implants over the last few years.What Raza does with implants that have two or three threads exposed on the buccal.Why Raza uses an implantoplasty to treat implants that have deteriorated.The level of bone loss or peri-implantitis which prompts Raza to intervene.The importance of having a good relationship with the restorative doctor when treating peri-implantitis.Patients are unlikely to change their habits, so surgeons should try new techniques.Hear why removing transmandibular implants is so difficult.Insights into the trickiest case Raza has had to treat that involved necrotizing fasciitis.Why Raza has not changed his third molar extraction technique much over the years.Coronectomy versus piezo: Which technique results in greater complication.Tried and trusted methods; why Raza sticks with a regular course of antibiotic treatment for third molar extractions.How Raza’s anesthetic technique has changed seeing as his wife is an anesthesiologist.Why trying to take oral surgeons’ right to outpatient anesthesia is misguided.Raza’s firm approach to putting patients to sleep and why he does not tolerate joking around at that time.The bad press that oral and maxillofacial surgeons get when anesthesia goes wrong.Negative outcomes of not allowing oral and maxillofacial surgeons to administer anesthesia.What oral maxillofacial surgeons in private practice can do to support the profession’s rights.The complications that Raza has seen with TMJ disorders and his preferred courses of treatment.Links Mentioned in Today’s Episode:Dr. Raza HussainUniversity of Illinois at Chicago (UIC) College of DentistryJesse Brown VA Medical CenterAAOMS

Today Dr. Stucki interviews Dr. Scott Weiskopf, an oral and maxillofacial surgeon practicing in Tennessee in the Memphis area. Ever since he introduced a fully digital workflow and started printing his own surgical guides, his dental surgery practice has been transformed because it allows him to produce and place top-quality implants. In this conversation, Dr. Weiskopf shares how his appointments with patients who need implants typically proceed, when in the process the guides are made, and the handful of cases where placing the implant freehand is still better. Tuning in, listeners will get a sense of the cost implications of printing the guides yourself, how it benefits your patients and practice, and where you can purchase the cheapest – yet effective – 3D printing equipment. Our guest shares details on his grafting techniques and materials, how he approaches third molar extractions, and what he favors in terms of instruments. The two also discuss drugs and dosages and share a bit about their work philosophies. Key Points From This Episode:What switching over to a fully digital workflow meant for his dental surgery practice. The benefits of having surgical guides when doing implants.Get a sense of how the appointments proceed for implant consultations and surgery. The cost implications of printing the guides yourself rather than having it printed by a big lab. Where you can purchase a 3D printer and why you don’t need a dental-specific one. Dr. Weiskopf talks about the handful of times he has had to adjust the guides. Learn why he works almost exclusively with the Straumann Dental Implant System.    What his grafting technique looks like and why he switched to a different membrane. Dr. Weiskopf’s graft materials of choice, including allograft, xenograft, and DBM putty. How using the guides differs from placing the implants freehand and when the latter is more appropriate. The benefits of having patients see and ask about the latest in dental technology. How your software determines the ease with which multiple implants can be created. Learn what has changed in his third molar extraction technique since his residency. Dr. Weiskopf talks about his preferred tools and why he picks up the instruments himself. The value of having a second assistant and what his typical drugs and dosages involve. The idea that when you permit something, you are inadvertently promoting it. Links Mentioned in Today’s Episode:Dr. Scott Weiskopf Straumann Dental Implant System Nobel BiocareBioXclude 

In this solo episode with your host Dr. Grant Stucki, listeners will hear all about avoiding the mistake of taking out the wrong tooth. While this is not a glamorous topic, it is still an important one since too many patients have left their dentist’s office with the wrong tooth missing. Very little is said and taught on this issue because it seems like such a simple thing to get right. In general surgery, doctors initial the area of the body that will be operated on to ensure that everyone is on the same page and the right part of the body is identified. Even so, there have been instances where a patient who needed a hip replacement left with a tendon repair they didn’t need, so removing the wrong tooth is not so far fetched. Just the idea of making this mistake puts some oral surgeons in a low-grade seizure state, especially if they’ve come close to this experience. Today Dr. Stucki shares examples of some of the cases where you might be more likely to make a mistake or be distracted and discusses some of his trusted procedures to ensure that he gets the right tooth every time. Key Points From This Episode:Dr. Stucki shares his experience of taking out the wrong tooth during his residency training. How difficult it was for him to get over the mistake and how affected his confidence level. The identifiers he looks for on the referral notes to ensure that he works on the right tooth. Checking the financial agreement to see which procedures have been signed and paid for. The procedure he walks through with every patient to identify and verify the right tooth.  What Dr. Stucki does right before he begins working on the tooth.The importance of the surgeon, patient, and assistant being on the same page. Awareness of scenarios and cases in which you are more likely to remove the wrong tooth. What plowing down cactuses in Tucson, Arizona, and today’s topic have in common. Examples of high-risk cases for taking out the wrong tooth, including two impacted molars. What you can do to ensure that you have identified the correct supernumerary tooth.  How time constraints can contribute to you confusing patients and cases.Internal and external distractions that can give way to mistakes during surgery.

Although residency training can be comprehensive in many ways, it is vital to find what works for you as a surgeon once you are in practice. Today’s guest, Dr. David Salomon, has done just that, tweaking his anesthesia technique over time to administer it efficiently, in the least resource-heavy way possible. As a prestigious doctor working in Connecticut, David runs a successful private practice. In this episode, David talks about why he has mostly stopped using fentanyl and the results he has seen from making this change. While David has been open to changing his anesthesia technique, he also recognizes that it is not possible to have a one-size-fits-all plan for every patient. He talks about developing your intuition to understand what a patient needs. We also learn more about David’s grafting technique, some of the tweaks he is currently making, and the outcomes so far. We then turn our attention to the practice side of things, where David talks about some of the daily difficulties he faces, the role his assistants play and how he handles their training, and the importance of communicating and managing expectations. Not only is David an excellent surgeon technically, but the care and empathy he extends to his patients really sets him apart. To hear more from this inspiring doctor, be sure to tune in today!Key Points From This Episode:Some of the small things David has changed in his practice that have had a big impact.David’s grafting technique and how it has evolved over time.Two things David has noticed about nylon sutures compared with chromic and vicryl sutures.The differences between mineralized and demineralized bone grafts.Techniques David is implementing from Bone Augmentation in Implant Dentistry.Why David does not do that many immediate implants.What David has seen with how some patients get inflamed after a bone graft.How David manages patients’ pain and how he guides them through it. David’s typical sedation protocol and his approach to optimizing the process.How David handles children and adults who are afraid of needles.The most challenging things that come up in David’s daily practice.Why David usually does not sedate children and what he does instead.David’s interest in music, the band he was in for years, and playing songs during surgery.How David has trained his assistants and his emphasis on self-sufficiency.Why David prefers to grab his own tools and do the sutures himself.Benefits of waiting until the end of a procedure to do the sutures.The role an office manager can play in managing assistants and dealing with issues.Keeping lines of communication open and how this counteracts drama with staff.The importance of being a good listener and making patients feel heard and understood.Communicating potential risks in a more human way and how David tackles this.How an empathetic approach can help with even the most difficult patient.The question David asks to break the ice when he meets clients for a consult.David's positive experience of residency and the feeling of camaraderie he misses.Links Mentioned in Today’s Episode:Dr. David SalomonBone Augmentation in Implant DentistryPickles PubDr. Grant Stucki